This proposal builds upon the previous successful Middle East Research Ethics Training Initiative (MERETI) that has been in existence since 2005 (FIC-NIH Grant R25TW007090). The overall goal of this training program is to ensure the sustainability of individual and institutional research ethics capacity in the Middle East so that y the end of this grant cycle, further advanced training of individuals in research ethics will occur primarily within institutions in this region. We will focus on the countries of Egypt, Sudan, and Morocco, where we have trained a cadre of individuals who will be able to design and direct research ethics activities related to clinical and public health research at their home institution. To achieve these goals we are proposing several Specific Aims. First, we will continue with our 2-year blended onsite/online training program that involves a 3- week program at the University of Maryland, Baltimore followed by an online graduate certificate degree program in research ethics (12 credits). We have added additional competencies that will provide our trainees with the skills needed to sustain their ethics activities at their home institutions (e.g., grant and manuscript writing, teaching skills, communication skills, and presentation skills). Our second specific aim will involve the development a professional development program that will consist of a structured Individual Development Plan that will ensure a more organized approach to the professional development and career advancement of our trainees. Post-training activities includes opportunities to teach in our intramural training programs and opportunities to network with the other MERETI participants and other professionals within the Middle East region. To ensure institutional sustainability, our next Specific Aim calls for us to collaborate with Dr. Sar Lavinia Brair, a Principal Investigator on this proposal, to develop blended diploma programs in research ethics at Al Neelain University in Khartoum, Sudan. These programs will be sustainable from the tuition fees generated from these diploma programs. Our fourth specific aim entails our collaboration with Dr. Hany Sleem from Cairo, Egypt, the other Principal Investigator on this proposal. We will enhance the sustainability of the Egyptian Network of Research Ethics Committees (ENREC) by developing and offering online Continuing Medical Education (CMEs) courses. Registration fees will be generated from these courses that will help ENREC to sustain its activities. Finally, we have established strong ties with Fez University and Cadi Ayyad University in Morocco from which we have started to train a critical mass of trainees. The goal is that these and other future trainees will become ethics leaders at their institutions and build sustainable ethics training programs and functional RECs.